Women survivors of female genital mutilation/cutting as ambassadors of Change

A participatory action research for eradication of FGM/C in Somaliland

Primary investigator: Beth Maina Ahlberg

This project proposal is about eradication of Female genital mutilation (FGM/C. It involves women who require and have undergone surgery to repair the damage caused by FGM/C. The study aims to start a collaborative process where these women can be voices regarding the complications of FGM/C as basis for eradication. In this way, the project is a type of scaling up in engaging communities using the health of women and a bottom up approach to eradication.

The woman may develop complications such as dysmenorrhea or stagnation of menstrual blood, recurrent urinary tract infection, dyspareunia, infertility, vulva keloids and dermal cysts that cause pain especially during menstruation and sexual intercourse. Women are also ordinarily, fatigued by all these complications and pain and are therefore unable to perform their daily household routines. Other complications occur during pregnancy and birth. Labour may for example, be obstructed and could lead to death of the baby and the mother if early medical intervention is not provided. In addition, there is the added risk of damage to the vagina after birth, leading to formation of fistulas into the bladder and/or the bowels, causing incontinence, a condition that leads to rejection of women by their families, thus exacerbating psychological stress and traumas

The question is why a practice that inflicts such damage to the health of women, continues, even when knowledge of the damage is abundant. Why is it, as indicated by WHO (2008) that decades of prevention work by local communities, governments, and national and international organizations have only contributed to limited reduction in prevalence of female genital mutilation in some areas, while the overall rate of decline has been slow? The WHO (2008) nonetheless also offers some indication that it may be the approaches used. Where communities have employed a process of collective decision-making, they have been able to abandon the practice. This is to say that rather than the problem being as some may argue an issue of obstinate culture or religion, it is the eradication approaches used that seem to be the issue. It is in this context that we aim to use collaborative or participatory action research starting with women survivors as the initial agents for mobilizing community members for eradication.